‘Fear factor’ hits hospital surgery staff

Staff at Addenbrooke’s are feeling the “fear factor” after a series of major blunders during operations.

The Cambridge hospital has been ordered to improve by regulators after eight botched surgeries since September 2011 – which included operating on the wrong patient and leaving medical instruments inside another two.

A report released yesterday into “never events” found staff are now so scared of making a mistake it has led to “extreme checking” at the expense of patient care and time.

In a section of the independent review called “the fear factor”, Danny Keenan, a professor of cardiothoracic surgery in Manchester, said: “There is a perception among staff that if the checklist is not followed to the letter, and anything goes wrong, they will be seriously chastised.

“This makes checking of instruments very laborious and slow.”

The report found hospital workers do not like the fact the “instrument count is laborious and time consuming so staff are taken away from direct patient care”.

One staff member told the authors the “focus on the checklist was so extreme it detracted from other safety factors like observing the patient”.

In a survey carried out as part of the review, 80 per cent of theatre staff said they would be happy to be treated as a patient at their own trust – leaving the remaining one in five less than happy at the prospect.

The report, which was handed to a meeting of the board of directors of Cambridge University Hospitals NHS Foundation Trust yesterday, concluded it was “reassured” the problems identified in a report on the ‘never events’ by a health watchdog, the Care Quality Commission, earlier this year had been addressed and the trust was learning from blunders thanks to “quite a radical action plan”.

The meeting also heard staff morale had taken a hit, with scores going down in 18 of 22 categories between March and October.

The percentage of staff who enjoyed working in the trust fell from 83 to 79 per cent and less than two-thirds (63 per cent) said they felt valued.

Last month, the hospital was placed in special measures and ordered to appoint a new director after it consistently failed to meet key targets including waiting times for cancer treatment and accident and emergency.

The regulator said the series of ‘never events’ at the hospital had compounded its decision to order improvement.

Dr Mike Knapton, a Cambridge GP for 30 years and one of three new non-executive directors of the board brought in since the Monitor and CQC reports, told the meeting he was worried by the low scores for development at the university hospital.

Under 60 per cent of staff said the organisation is “committed to training and developing its staff” – down 15 per cent since 2009.

Dr Knapton, who trained at Addenbrooke’s in the 1980s, said: “It seems odd for a teaching hospital to go down like that in development. It may be that when the trust is under pressure to deliver targets the medium to long-term aims of training are not a priority.”

A trust spokeswoman said the staff survey scores had remained “relatively stable” since 2009 but accepted there had been a general downward trend and they were analysing comments made by staff to “help shape action plans”.